SWINE FLU - UPDATES & USEFUL INFORMATION

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U.S. customs officials began checking people entering U.S. territory. Millions of doses of flu-fighting medications from a federal stockpile were on their way to states, with priority given to the five already affected and to border states. Federal agencies were conferring with state and international governments.

"We want to make sure that we have equipment where it needs to be, people where they need to be and, most important, information shared at all levels," said Janet Napolitano, head of the Homeland Security Department.

"We are proceeding as if we are preparatory to a full pandemic," Napolitano said.

She said travel warnings for trips to Mexico would remain in place as long as swine flu is detected.

Mexico canceled school at all levels nationwide until May 6, and the Mexico City government said it was considering a complete shutdown, including all public transportation, if the death toll keeps rising. Labor Secretary Javier Lozano Alarcon said employers should isolate anyone showing up for work with fever, cough, sore throat or other signs of the flu.

Even some of Mexico's most treasured national holidays were affected by the swine flu alert.

Authorities announced Monday the cancellation of the annual Cinco de Mayo parade, in which people in period costumes celebrate Mexican troops' defeat of a French army on May 5, 1862. The national labor umbrella group announced the cancellation of Mexico City's traditional May 1 parade and the National Institute of Anthropology and History said all of its 116 museums nationwide would be closed until further notice.

Amid the warnings, the Mexican government grappled with increasing criticism of its response. At least two weeks after the first swine flu case, the government has yet to say where and how the outbreak began or give details on the victims.

The health department lacked the staff to visit the homes of all those suspected to have died from the disease, Cordova said.

Cordova said 1,995 people have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported April 13. The government does not yet know how many were swine flu.

He said tests show a 4-year-old boy contracted the virus before April 2 in Veracruz state, where a community has been protesting pollution from a large pig farm.

The farm is run by Granjas Carroll de Mexico, a joint venture half owned by Virginia-based Smithfield Foods, Inc. Spokeswoman Keira Ullrich said the company has found no clinical signs or symptoms of the presence of swine flu in its herd or its employees working anywhere in Mexico.

Mexico's Agriculture Department said Monday that its inspectors found no sign of swine flu among pigs around the farm in Veracruz, and that no infected pigs have been found yet anywhere in Mexico.

As if the country did not have enough to deal with, Cordova's comments were briefly interrupted by a 5.6-magnitude earthquake in southern Mexico that rattled already jittery nerves and sent mask-wearing office workers into the streets of the capital.

Aside from the confirmed cases, 13 are suspected in New Zealand, and one is suspected in both France and Israel.

European Union Health Commissioner Androulla Vassiliou advised Europeans to avoid nonessential travel to Mexico and parts of the United States, although Besser said that including the U.S. in the advisory seemed unwarranted at this time.

State Department spokesman Robert A. Wood said Vassiliou's remarks were his "personal opinion," not an official EU position, and therefore the department had no comment.

"We don't want people to panic at this point," Wood said.

The U.S. stepped up checks of people entering the country by air, land and sea, and the State Department warned U.S. citizens to avoid nonessential travel to Mexico. It said those who live in Mexico should avoid hospitals or clinics there unless they have a medical emergency.

The best way to keep the disease from spreading, Besser said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well. He said authorities are not recommending that people wear masks at work because evidence that it is effective "is not that strong."

Besser said about 11 million doses of flu-fighting drugs from a federal stockpile have been sent to states in case they are needed. That's roughly one quarter of the doses in the stockpile, he said.

There is no vaccine available to prevent the specific strain now being seen, he said, but some antiflu drugs do work once someone is sick.

If a new vaccine eventually is ordered, the CDC already has taken a key preliminary step — creating what's called seed stock of the virus that manufacturers would use.

Many of the cases outside Mexico have been relatively mild. Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

European and U.S. markets bounced back from early losses as pharmaceutical stocks were lifted by expectations that health authorities will increase stockpiles of anti-viral drugs. Stocks of airlines, hotels and other travel-related companies posted sharper losses.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

Governments in Asia — with potent memories of previous flu outbreaks — were especially cautious. Singapore, Thailand, Japan, Indonesia and the Philippines dusted off thermal scanners used in the 2003 SARS crisis and were checking for signs of fever among passengers from North America. South Korea, India and Indonesia also announced screening.

In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

China, Russia and Ukraine were among countries banning imports of pork and pork products from Mexico and three U.S. states that have reported swine flu cases, while other countries, such as Indonesia, banned all pork imports.

The CDC says people cannot get the flu by eating pork or pork products.

Germany's leading vacation tour operators were skipping stops in Mexico City as a precaution. The Hannover-based TUI said trips through May 4 to Mexico City were being suspended, including those operated by TUI itself and through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur.

Japan's largest tour agency, JTB Corp., suspended tours to Mexico through June 30. Russian travel agencies said about a third of those planning to travel to Mexico in early May had already canceled.

___




On the Net:

WHO swine flu page: http://www.who.int/csr/disease/swineflu/en/index.html

CDC: http://www.cdc.gov

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                                        Mexico faces severe criticism over slow swine flu response






Niko Price,
Associated Press Writer
– 11 mins ago
April 27, 2009
MEXICO CITY

– Two weeks after the first known swine flu death, Mexico still hasn't given medicine to the families of the dead.
It hasn't determined where the outbreak began or how it spread. And while the government urges anyone who
feels sick to go to hospitals, feverish people complain ambulance workers are scared to pick them up.

A portrait is emerging of a slow and confused response by Mexico to the gathering swine flu epidemic. And that
could mean the world is flying blind into a global health storm.

Despite an annual budget of more than $5 billion, Mexico's health secretary said Monday that his agency hasn't
had the resources to visit the families of the dead. That means doctors haven't begun treatment for the population most exposed to swine flu, and most apt to spread it.

It also means medical sleuths don't know how the victims were infected — key to understanding how the epidemic began and how it can be contained.

Foreign health officials were hesitant Monday to speak critically about Mexico's response, saying they want to wait until more details emerge before passing judgment. But already, Mexicans were questioning the government's image
of a country that has the crisis under control.

"Nobody believes the government anymore," said Edgar Rocha, a 28-year-old office messenger. He said the lack of information is sowing distrust: "You haven't seen a single interview with the sick!"

The political consequences could be serious. China was heavily criticized during the outbreak of SARS for failing to release details about the disease, feeding rumors and fear. And Mexico's failed response to a catastrophic 1985 earthquake is largely credited with the demise of the party that had ruled the country since the 1920s.

"That is foremost in the minds of Mexican policymakers now," said George Grayson at the College of William & Mary
in Virginia. "They're thinking, 'We don't want another '85.'"

Indeed, Health Secretary Jose Angel Cordova was defensive at a news conference Monday as he was peppered with questions about why Mexico took so long to identify the outbreak, attempt to contain its spread and provide information.

"We never had this kind of epidemic in the world," he said. "This is the first time we have this kind of virus."

It remained unclear where and how the epidemic began, how it has spread, who it has killed or how fast it is growing. And the government has yet to take some basic steps critical to containing any outbreak, such as quick treatment of people who had contact with the victims.

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In the town of Xonacatlan, just west of Mexico City, Antonia Cortes Borbolla told The Associated Press that nobody has given her medicine in the week since her husband succumbed to raging fever and weakened lungs that a lab has confirmed as swine flu.

No health workers have inspected her home, asked how her husband might have contracted the illness or tested the neighbors' pigs, she said.

Cordova acknowledged that her case isn't unique.

"We haven't given medicine to all of them because we still don't have enough personnel," he said.

Cordova said he couldn't provide information on the victims for reasons of confidentiality, but promised to eventually release a statistical breakdown. He said he couldn't provide that data now "because it's being processed."

Asked whether he could at least say how many of the 20 confirmed victims were men and how many were women, he said: "I don't have that information."

The government has insisted it acted quickly and decisively when presented with the evidence of a new virus.

But even as it did so, it acknowledged the outbreak began earlier than April 12, the date it had previously linked to the first case. Cordova confirmed Monday that a 4-year-old boy who was part of an outbreak in eastern Veracruz state that began in February had swine flu. He later recovered.

Residents of the town of Perote said at the time that they had a new, aggressive bug — even taking to the streets to demonstrate against the pig farm they blamed for their illness — but were told they were suffering from a typical flu. It was only after U.S. labs confirmed a swine flu outbreak that Mexican officials sent the boy's sample in for swine flu testing.

Mexico's Agriculture Department said Monday that inspectors found no sign of swine flu among pigs around the farm in Veracruz, and that no infected pigs have been found yet anywhere in Mexico.

Meanwhile, some people complained that health workers were turning them away, even as officials urged people to seek treatment quickly if they felt symptoms of flu coming on.

Elias Camacho, a 31-year-old truck driver with fever, cough and body aches, was ordered out of a government ambulance Sunday because paramedics complained he might be contagious, his father-in-law told the AP. When family members took him to a hospital in a taxi, Jorge Martinez Cruz said, a doctor told him he wasn't sick.

Camacho was finally admitted to the hospital — and placed in an area marked "restricted" — after a doctor at a private clinic notified state health authorities, Martinez said.

In Mexico City, Jose Isaac Cepeda said two hospitals refused to treat his fever, diarrhea and joint pains. The first turned him away because he wasn't registered in the public health system, he said.

The second, he said, didn't let him in "because they say they're too busy."

___



Associated Press writers

Olga Rodriguez
in Xonacatlan and

Peter Orsi and
Lisa J. Adams
in Mexico City

contributed to this report.

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                                 What you need to know about swine flu







Lauran Neergaard,
Ap Medical Writer
Apr 27, 2009
WASHINGTON

– A never-before-seen strain of swine flu has turned killer in Mexico and is causing milder illness in the United States and elsewhere. While authorities say it's not time to panic, they are taking steps to stem the spread and also urging people to pay close attention to the latest health warnings and take their own precautions.

"Individuals have a key role to play," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Monday.

Here's what you need to know:

Q: How do I protect myself and my family?

A: For now, take commonsense precautions. Cover your coughs and sneezes, with a tissue that you throw away or by sneezing into your elbow rather than your hand. Wash hands frequently; if soap and water aren't available, hand gels can substitute. Stay home if you're sick and keep children home from school if they are.

Q: How easy is it to catch this virus?

A: Scientists don't yet know if it takes fairly close or prolonged contact with someone who's sick, or if it's more easily spread. But in general, flu viruses spread through uncovered coughs and sneezes or — and this is important — by touching your mouth or nose with unwashed hands. Flu viruses can live on surfaces for several hours, like a doorknob just touched by someone who sneezed into his hand.

Q: In Mexico, officials are handing out face masks. Do I need one?

A: The CDC says there's not good evidence that masks really help outside of health care settings. It's safer just to avoid close contact with someone who's sick and avoid crowded gatherings in places where swine flu is known to be spreading. But if you can't do that, CDC guidelines say it's OK to consider a mask — just don't let it substitute for good precautions.

Q: Is swine flu treatable?

A: Yes, with the flu drugs Tamiflu or Relenza, but not with two older flu medications.

Q: Is there enough?

A: Yes. The federal government has stockpiled enough of the drugs to treat 50 million people, and many states have additional stocks. As a precaution, the CDC has shipped a quarter of that supply to the states to keep on hand just in case the virus starts spreading more than it has so far.

Q: Should I take Tamiflu as a precaution if I'm not sick yet?

A: No. "What are you going to do with it, use it when you get a sniffle?" asks Dr. Marc Siegel of New York University Langone Medical Center and author of "Bird Flu: Everything you Need To Know About The Next Pandemic." Overusing antiviral drugs can help germs become resistant to them.

Q: How big is my risk?

A: For most people, very low. Outside of Mexico, so far clusters of illnesses seem related to Mexican travel. New York City's cluster, for instance, consists of students and family members at one school where some students came back ill from spring break in Mexico.

Q: Why are people dying in Mexico and not here?

A: That's a mystery. First, understand that no one really knows just how many people in Mexico are dying of this flu strain, or how many have it. Only a fraction of the suspected deaths have been tested and confirmed as swine flu, and some initially suspected cases were caused by something else.

Q: Should I cancel my planned trip to Mexico?

A: The U.S. did issue a travel advisory Monday discouraging nonessential travel there.

Q: What else is the U.S., or anyone else, doing to try to stop this virus?

A: The U.S. is beginning limited screening of travelers from Mexico, so that the obviously sick can be sent for treatment. Other governments have issued their own travel warnings and restrictions. Mexico is taking the biggest steps, closings that limit most crowded gatherings. In the U.S., communities with clusters of illness also may limit contact — New York closed the affected school for a few days, for example — so stay tuned to hear if your area eventually is affected.

Q: What are the symptoms?

A: They're similar to regular human flu — a fever, cough, sore throat, body aches, headache, chills and fatigue. Some people also have diarrhea and vomiting.

Q: How do I know if I should see a doctor? Maybe my symptoms are from something else — like pollen?

A: Health authorities say if you live in places where swine flu cases have been confirmed, or you recently traveled to Mexico, and you have flulike symptoms, ask your doctor if you need treatment or to be tested. Allergies won't cause a fever. And run-of-the-mill stomach bugs won't be accompanied by respiratory symptoms, notes Dr. Wayne Reynolds of Newport News, Va., spokesman for the American Academy of Family Physicians.

Q: Is there a vaccine to prevent this new infection?

A: No. And CDC's initial testing suggests that last winter's flu shot didn't offer any cross-protection.

Q: How long would it take to produce a vaccine?

A: A few months. The CDC has created what's called "seed stock" of the new virus that manufacturers would need to start production. But the government hasn't yet decided if the outbreak is bad enough to order that.

Q: What is swine flu?

A: Pigs spread their own strains of influenza and every so often people catch one, usually after contact with the animals. This new strain is a mix of pig viruses with some human and bird viruses. Unlike more typical swine flu, it is spreading person-to-person. A 1976 outbreak of another unusual swine flu at Fort Dix, N.J., prompted a problematic mass vaccination campaign, but that time the flu fizzled out.

Q: So is it safe to eat pork?

A: Yes. Swine influenza viruses don't spread through food.

Q: And whatever happened to bird flu? Wasn't that supposed to be the next pandemic?

A: Specialists have long warned that the issue is a never-before-seen strain that people have little if any natural immunity to, regardless of whether it seems to originate from a bird or a pig. Bird flu hasn't gone away; scientists are tracking it, too.

___



EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.



On the Net:

U.S. government flu info: http://www.hhs.gov/web/library/index.html

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                                                 Flu Special Report: The Basics
           




 
Livescience Staff
livescience.com
– Sun Apr 26, 6:15 pm ET

With swine flu outbreaks creating what U.S. health officials Sunday called a public health emergency, LiveScience presents a 4-part Flu Special Report this week to examines the science of influenza, what you can do to be safe, and the risk of a pandemic. Part 1 today: Flu basics.


The flu virus is most commonly spread in liquid droplets made airborne by coughing or sneezing. Symptoms - such as fever, body ache, extreme fatigue, sore throat, and dry cough - begin showing in adults one to four days after being infected.


The new strain of swine flu is spreading from human to human, but the Centers for Disease Control and Prevention (CDC) doesn't yet know how contagious it is. Bird flu, which has in recent years concerned scientists, has been slow to transmit between humans.


A study in 2006 showed that modern travel could contribute to spreading a flu pandemic across the United States in as little as three months.


An adult can begin spreading the flu virus one day before and three to seven days after symptoms show, and children can remain contagious even longer. Some infected individuals show no symptoms, yet they can still spread the virus to others.





Among the best preventative measures you can take, according to the CDC:



Wash hands with soap or alcohol-based sanitizers;

Avoid touching your eyes, nose or mouth;

avoid contact with sick people;

and wear a face mask.

For the elderly and the young, flu vaccines can be crucial, but they only work when designed for a specific flu strain.





Year-round problem



Many people think of the flu as a winter disease since incidence typically peaks from December to March. It's actually a year-round problem.


But people tend to stay indoors more in the winter, making person-to-person transmission of influenza, which is caused by a virus, easier, said Jennifer Morcone, a spokeswoman for the CDC. Further, a study in 2007 revealed that the influenza virus thrives on cold temperatures and low relative humidity, allowing them to remain virulent longer in the air or on surfaces after being sneezed out of an infected person.


Each year anywhere from 5 to 20 percent of the U.S. population gets the flu. Anyone can contract it, but children, the elderly and people with chronic medical conditions are more likely to experience complications, such as pneumonia, bronchitis, and sinus and ear infections. However, the swine flu currently sweeping through Mexico and the United States has proven more problematic among healthy young adults.


The flu can also worsen chronic health problems: asthmatics are more likely to have asthma attacks and people with chronic congestive heart failure may have their condition worsen.


On average, 36,000 people in the United States die from influenza and related complications each year, according to the CDC. More than 200,000 are admitted to hospitals for treatment.


A pandemic in 1918 killed more than 20 million people worldwide.


The flu is sometimes confused with the common cold, and for good reason. Both are respiratory illnesses brought on by viruses. They share many of the same symptoms, and it is nearly impossible to make the distinction based on the variety of symptoms alone.


Flu symptoms, however, are generally more intense, especially fever and fatigue, and can lead to dangerous complications.

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Viral roots



Influenza is a virus - a pack of protein and DNA that lacks the capacity to self-reproduce. So it infects a cell, hijacks the inner machinery and uses it to reproduce. The virus reproduces until there are so many copies that the cell bursts and the virus spills out, spreading to other healthy cells.

There are three types of influenza viruses: A, B, and C. Swine flu (H1N1) and the much hyped avian flu (H5N1) are both Type A.

Type A: Infects people, pigs, birds, horses, seals, whales, and other animals. Wild birds are natural hosts. Divided into subtypes based on two surface proteins - hemagglutinin (HA) and neuraminidase (NA). There are 15 HA and 9 NA subtypes, and these can be combined in various ways. Currently, the three most common subtypes in general human circulation are H1N1, H1N2, and H3N2. These can cause epidemics - defined as a high incidence of disease in an area or population - and also a widespread geographic or global disease called a pandemic.

Type B: Normally occurs only in humans. No subtypes. Known to cause human epidemics, but not pandemics.

Type C: Only causes mild respiratory illness in humans, and is not included in flu vaccines. Not capable of epidemic or pandemic spread.



Types A and B are further characterized into genetic variants called "strains."

New strains are constantly evolving and take the place of older ones.

While your body may have built up resistance against one strain, it may not be able to fend off its replacement.

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                                    Israel, New Zealand latest countries hit by swine flu
     





MEXICO CITY
(Reuters)

– New Zealand and Israel confirmed cases of swine flu on Tuesday, the latest countries hit by a new strain that has killed up to 149 people in Mexico and which threatens to become a pandemic.

The World Health Organization has raised its alert level to phase 4, indicating a significantly increased risk of pandemic. Global markets tumbled for a second day on Tuesday on fears the outbreak could snuff out fragile signs of economic recovery.

No one has died outside Mexico but more than 50 infected people have been found in the United States, six in Canada and two each across the Atlantic in Spain and Scotland. Possible cases were being tested in South Korea and Australia.

New Zealand said three of 11 people in a school group that visited Mexico had tested positive and it expected the others would also turn out to be positive when tests were completed.

Health Minister Tony Ryall said all those affected appeared to have only mild symptoms and had been responding to treatment.

Authorities have tracked down most of the 356 people on the same flight from Los Angeles as the infected students.

The Israeli carrier, a 26-year-old man, had also recently returned from Mexico.

"His condition is good but he is being kept hospitalized for observation," health ministry spokeswoman Einav Shimron said.

One of the mysteries of the current outbreak is why all cases outside Mexico have so far been relatively mild.

The WHO said the flu was being spread by human-to-human transmission but it did not advise any travel restrictions or border closures.

Asian and European stock markets retreated, with airline stocks taking another hit and drug makers posting gains. The yen climbed to a seven-week high against the euro and a one-month high versus the dollar as investors cut their exposure to riskier currencies.

Oil dropped 2 percent, sinking below $50 a barrel.

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                                     Swine flu spreads to Middle East, Asia-Pacific
           





Andrew O. Selsky,
Associated Press Writer
April 28, 2009
MEXICO CITY

– The swine flu epidemic crossed new borders Tuesday with the first cases confirmed in the Middle East and the Asia-Pacific region, as the number of deaths in Mexico blamed on the virus surpassed 150.

With the swine flu having already spread to at least six other countries besides Mexico, authorities around the globe are like firefighters battling a blaze without knowing how far it extends.

"At this time, containment is not a feasible option," said Keiji Fukuda, assistant director-general of the World Health Organization, which raised its alert level on Monday.

New Zealand reported Tuesday that 11 people who recently returned from Mexico contracted the virus. Tests conducted at a World Health Organization laboratory in Australia had confirmed three cases of swine flu among 11 members of the group who were showing symptoms, New Zealand Health Minister Tony Ryall said.

Officials decided that was evidence enough to assume the whole group was infected, he said.

Those infected had suffered only "mild illness" and were expected to recover, Public Health Director Mark Jacobs said. There are 43 more suspected cases in the country, officials said.

The Israeli Health Ministry on Tuesday confirmed the region's first case of swine flu in the city of Netanya. The 26-year-old patient recently returned from Mexico and had contracted the same strain, Health Ministry spokeswoman Einav Shimron.

Dr. Avinoam Skolnik, Laniado Hospital's medical director, said the patient has fully recovered and is in "excellent condition" but will remain hospitalized until the Health Ministry approves his release.

Another suspected case has been tested at another Israeli hospital but results are not in, the ministry said.

Meanwhile, a second case was confirmed Tuesday in Spain, Health Minister Trinidad Jimenez said, a day after the country reported its first case. The 23-year-old student, one of 26 patients under observation, was not in serious condition, Jimenez said.

With the virus spreading, the U.S. prepared for the worst even as President Barack Obama tried to reassure Americans.

At the White House, a swine flu update was added to Obama's daily intelligence briefing. Obama said the outbreak is "not a cause for alarm," even as the U.S. stepped up checks of people entering the country and warned U.S. citizens to avoid nonessential travel to Mexico.

"We are proceeding as if we are preparatory to a full pandemic," said Homeland Security Secretary Janet Napolitano.

The European Union health commissioner suggested that Europeans avoid nonessential travel both to Mexico and parts of the United States. Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus.

Mexico, where the number of deaths believed caused by swine flu rose by 50 percent on Monday to 152, is suspected to be ground zero of the outbreak. But Mexican Health Secretary Jose Angel Cordova late Monday said no one knows where the outbreak began, and implied it may have started in the U.S.

"I think it is very risky to say, or want to say, what the point of origin or dissemination of it is, given that there had already been cases reported in southern California and Texas," Cordova told a press conference.

It's still not clear when the first case occurred, making it impossible thus far to determine where the breakout started.

Dr. Nancy Cox of the Atlanta-based Centers for Disease Control and Prevention has said she believes the earliest onset of swine flu in the United States happened on March 28. Cordova said a sample taken from a 4-year-old boy in Mexico's Veracruz state in early April tested positive for swine flu. However, it is not known when the boy, who later recovered, became infected.

The World Health Organization raised the alert level to Phase 4, meaning there is sustained human-to-human transmission of the virus causing outbreaks in at least one country. Monday was the first time it has ever been raised above Phase 3.

Putting an alert at Phases 4 or 5 signals that the virus is becoming increasingly adept at spreading among humans. Phase 6 is for a full-blown pandemic, characterized by outbreaks in at least two regions of the world.

Fifty cases — none fatal and most of them mild — were confirmed in the United States. Including the New Zealand, Israeli and new Spanish reports, there were 92 confirmed cases worldwide on Tuesday. That included six in Canada, one in Spain and two in Scotland.

Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.   

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Amid the alarm, there was a spot of good news. The number of new cases reported by Mexico's largest government hospitals has been declining the past three days, Cordova said, from 141 on Saturday to 119 on Sunday and 110 Monday.

In a bid to prevent mass contagion, Mexico canceled school nationwide until May 6, and the Mexico City government is considering a complete shutdown, including all public transportation. The Cinco de Mayo parade celebrating Mexico's defeat of a French army on May 5, 1862 and Mexico City's traditional May 1 parade were canceled. More than 100 museums nationwide were closed.

At Mexico City's international airport, families grimly waited for flights out of the capital or country, determined to keep their masks on until they touched ground somewhere else.

Three games involving Mexico City soccer clubs were played with no spectators over the weekend. Decio de Maria, secretary general of the Mexican soccer federation, said plans for future matches would be announced on Wednesday.

"The idea is to look for the fewest number of games that have to be played behind closed doors," he said. "If it's necessary, we'll play all the matches behind closed doors. We don't foresee canceling any games."

Many residents of Mexico City wore blue surgical masks, though the CDC said most masks offer little protection. Many victims have been in their 30s and 40s — not the very old or young who typically succumb to the flu. So far, no deaths from the new virus have been reported outside Mexico.

It could take four to six months before the first batch of vaccines are available, WHO officials said. Some antiflu drugs do work once someone is sick.

Napolitano, the U.S. Homeland Security chief, said Washington is dispatching people and equipment to affected areas and stepping up information-sharing at all levels of government and with other nations.

Richard Besser, the CDC's acting director, said his agency is aggressively looking for evidence of the disease spreading and probing for ways to control and prevent it.

Flu deaths are nothing new in the United States. The CDC estimates that about 36,000 people died of flu-related causes each year, on average, during the 1990s in the United States. But the new flu strain is a combination of pig, bird and human viruses that humans may have no natural immunity to.

Besser said that so far the virus in the United States seems less severe than in Mexico. Only one person has been hospitalized in the U.S.

"I wouldn't be overly reassured by that," Besser told reporters at CDC headquarters in Atlanta, sounding a cautionary note.

The best way to keep the disease from spreading, Besser said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

Governments in Asia — with memories of previous flu outbreaks — were especially cautious. Singapore, Thailand, Japan, Indonesia and the Philippines dusted off thermal scanners used in the 2003 SARS crisis and were checking for signs of fever among passengers from North America. South Korea, India and Indonesia also announced screening.

Teams of doctors, nurses and government officials boarded flights arriving in Japan from Mexico, the U.S. and Canada to check passengers for signs of the flu, Japanese Health Ministry official Akimori Mizuguchi said.

World stock markets fell Tuesday as investors worried that any swine flu pandemic could derail a global economic recovery.

__



AP writers


Mark Stevenson
in Mexico City,

Mike Stobbe
in Atlanta,

Ray Lilley
in Wellington, New Zealand,

Aron Heller
in Jerusalem and

Pan Pylas
in London

contributed to this report.

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                             Across Asia, mood calm but wary in face of swine flu threat
           





James Pomfret
– Tue Apr 28, 2009
HONG KONG
(Reuters)

– Across Asia, people are closely following the global spread of swine flu from Mexico and preparing for the worst after the World Health Organization raised its alert level for the outbreak.

Authorities in the region have boosted surveillance at airports and hospitals, stockpiled anti-viral drugs and other supplies to fight any outbreaks.

Face masks and anti-viral drugs like Relenza and Tamiflu flew off the shelves from pharmacies in some cities on Tuesday.

"It's really apparent, people have been buying face masks all day," said Cyrus Chan, the boss of a dispensary in Hong Kong's Wanchai bar district who had sold out his entire stock of 10,000 adult face-masks and only had child sizes left.

"Since SARS, this is the second time there's been such a great demand," Chan added, as a steady stream of customers asking for masks were told there wouldn't be any new stocks of adult masks till later.

Still, the mood on the streets appeared largely calm, with the world's most populous region, used to outbreaks of SARS and the H5N1 avian flu, not having yet reported any confirmed cases.

In South Korea, health authorities are testing a 51-year-old woman for suspected swine flu after a trip to Mexico.

"There hasn't been much of a reaction yet. I've just had a few calls asking if we have anti-viral drugs or special masks" said a pharmacist in downtown Seoul who asked not to be named.

"I guess South Koreans have grown accustomed to these breakouts over the past 10 years. But I will be bringing in more Tamiflu to the shelves."

[Bianca]

PARTICULARLY VULNERABLE

Asia's patchy medical infrastructure, poverty and vast populations in countries like China and India make it particularly vulnerable should the virus take hold and propagate.

China has vowed to disclose any human cases of swine fever promptly, while state-run newspapers on Tuesday urged officials to be open and avoid the kind of cover-ups that brought panic during the SARS epidemic.

The empty streets, schools and shops, worried citizens wearing masks and fleeing travelers now seen in Mexico are familiar to China, where in 2003 the SARS virus shut down much of the country, killing hundreds in the mainland and Hong Kong.

"I just want to be safe," said a Hong Kong man surnamed Cheng who bought 100 child face-masks for his nine-year-old daughter from the Wanchai pharmacy.

In Singapore, stocks of high-end N95 masks were being depleted in stores, with a sales attendant at Changi Airport saying new stocks wouldn't arrive till next week at the earliest.

"We've run out of the masks as people going to Europe or the U.S. are trying to resort to some protection from the flu."

New Zealand meanwhile has quarantined 10 people including a teacher and nine children from an Auckland school and treated them as likely swine flu victims

While the local community was initially stunned, the overall public mood has reportedly been mostly calm, with the cases appearing to be mild so far. A further 56 people are being monitored. In neighboring Australia, five suspected flu cases are also being monitored.

In Vietnam, there appeared to be a degree of confusion toward swine flu which is not in fact linked to pigs alone -- but an assortment of swine, human and avian viruses.

"Death is everyone's destiny but this will be my last pig blood pudding for a while until the flu warning is over," said truck driver Nguyen Huu Luong, as he finished a bright red bowl of fresh pig blood and herbs in downtown Hanoi.

The swine flu outbreak has killed up to 149 people in Mexico and world health experts moved closer to declaring it the first flu pandemic in 40 years.

The last such outbreak, a "Hong Kong" flu pandemic first detected in the former British colony in 1968, killed about one million people, while SARS in 2003 killed 299.

"SARS was like a rehearsal for us," said Wong Pak-keung, a taxi driver who recalled those dark days when streets emptied and few of the city's 7 million people left home without a face mask.

"After SARS, people are more prepared and know what to do."

[Bianca]

                                       Worst case scenario underlies US pandemic plan
           





Ricardo Alonso-zaldivar
Eileen Sullivan,
Associated Press Writers
April 28, 2009
WASHINGTON

– Two million dead. Hospitals overwhelmed. Schools closed. Swaths of empty seats at baseball stadiums and houses of worship. An economic recovery snuffed out. We're nowhere close to what government planners say would be a worst-case scenario: a global flu pandemic. But government leaders at all levels, and major employers, have spent nearly four years planning for one in series of exercises.

Their reports, reviewed by The Associated Press, and interviews with participants paint a grim picture of what could happen if the swine flu gets severely out of control.

A full-scale pandemic — if it ever comes — could be expected to claim the lives of about 2 percent of those infected, about 2 million Americans.

The government estimates that a pandemic like the 1918 Spanish flu would sicken 90 million Americans, or about 30 percent of the population. Of those, nearly 10 million would have to be admitted to a hospital, and nearly 1.5 million would need intensive care. About 750,000 would need the help of mechanical ventilators to keep breathing.

No one would be immune from the consequences, even those who don't get sick, according to worst-case exercises run by local and national agencies.

Schools would be closed to try to block the spread of illness, for example, but school buses might be used to take flu victims to alternative clinics rather than overcrowded hospitals.

A 2006 report on the Washington region found both Maryland and Virginia would run out of hospital beds within two weeks of a moderate outbreak.

People who got sick would be isolated, and their relatives could be quarantined.

But even if families weren't required to stay home, many would do so to take care of sick relatives, or because they were afraid of getting sick themselves.

Hotels, restaurants and airlines would face loss of business as business travel and meetings would be replaced by teleconferences.

In the cities, commuters who do go to work might bike or walk instead of using mass transit.

People would avoid movie theaters and rent DVDs instead.

In 1918, authorities even called on churches to cancel services, to the chagrin of some pastors.

Society as a whole would go into a defensive crouch, and that would deliver a shock to the economy.

The Trust for America's Health, an independent public health group, estimated in 2007 that a severe pandemic would shrink U.S. output by about 5.5 percent.

Take a breath. Even if the new swine flu from Mexico turns out to be especially aggressive, the worst consequences could be averted.

Although some states are less prepared than others, the nation has made strides in stockpiling antiviral medicines, speeding the production of vaccines and laying down basic public health guidelines.

Homeland Security Secretary Janet Napolitano said Monday that the U.S. is preparing as if the swine flu outbreak were a full pandemic. It is not at that stage and may never reach it.

Disease detectives are following a series of outbreaks, of varying severity, all of which appear to be related to Mexico. A pandemic would spread throughout the world with explosive speed.

The government got serious about worst-case planning during the 2005 bird flu scare, as the lessons of Hurricane Katrina loomed large.

"We have a playbook that was developed and is being followed," said Michael Leavitt, who as secretary of Health and Human Services oversaw pandemic planning for President George W. Bush. "It's a substantially better picture than what we faced three years ago."

___



On the Net:

U.S. information on swine flu:
http://www.pandemicflu.gov

[Bianca]

                                    Swine flu's ground zero? Residents say nearby farm
           





Olga R. Rodriguez,
Associated Press Writer
– Tue Apr 28, 2009
LA GLORIA,
Mexico

– Residents in this community of 3,000 believe their town is ground zero for the swine flu epidemic, even if health officials aren't saying so.

More than 450 residents say they're suffering from respiratory problems from contamination spread by pig waste at nearby breeding farms co-owned by a U.S. company. Officials with the company say they've found no sign of swine flu on its farms, and Mexican authorities haven't determined the outbreak's origin.

The swine flu strain is suspected in more than 150 deaths in Mexico and cases have been confirmed in at least four other countries.

As far back as late March, roughly one-sixth of the residents here in the Gulf Coast state of Veracruz began complaining of respiratory infections that they say can be traced to a farm that lies upwind five miles (8.5 kilometers) to the north, in the town of Xaltepec.

But Jose Luis Martinez, a 34-year-old resident of La Gloria, said he knew the minute he learned about the outbreak on the news and heard a description of the symptoms: fever, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

"When we saw it on the television, we said to ourselves, 'This is what we had,'" he said Monday. "It all came from here. ... The symptoms they are suffering are the same that we had here."

Martinez and Bertha Crisostomo, a liaison between the villagers and the municipal government of Perote to which La Gloria belongs, say half of the people from the town live and work in Mexico City most of the week, and could easily have spread the swine flu in the capital, where the largest number of cases have been reported.

Granjas Carroll de Mexico, 50 percent owned by Virginia-based Smithfield Foods, Inc., has eight farms in the area. Smithfield spokeswoman Keira Ullrich said the company has found no clinical signs or symptoms of the presence of swine influenza in its swine herd or its employees working at its joint ventures anywhere in Mexico.

Residents say they have been bothered for years by the fetid smell of one the farms, which lies upwind of the community, and they suspect their water and air has been contaminated by waste.

When Associated Press journalists entered the farm on Monday, the cars were sprayed with water. Manager Victor Ochoa required the visitors to shower and don white overalls, rubber boots and masks before entering any of the 18 warehouses where 15,000 pigs are kept.

Ochoa showed the journalists a black plastic lid that covered a swimming pool-size cement container of pig feces to prevent exposure to the outside air.

"All of our pigs have been adequately vaccinated and they are all taken care of according to current sanitation rules," Ochoa said. "What happened in La Gloria was an unfortunate coincidence with a big and serious problem that is happening now with this new flu virus."

Martinez said residents have been fighting for years to force the company to improve their pig-waste management. Mexican news media reported that a municipal health official traced the source of a disease outbreak in La Gloria to a type of fly that reproduces in pig waste.

Local health officials and Federal Health Secretary Jose Angel Cordova downplayed claims that the swine flu epidemic could have started in la Gloria, noting that of 30 mucous samples taken from victims of respiratory diseases there, only one — that of 4-year-old Edgar Hernandez — came back positive. The boy later recovered.

Cordova insisted the rest of the community had suffered from a common influenza.

Mexican Agriculture Department officials said Monday that its inspectors found no sign of swine flu among pigs around the farm in Veracruz, and that no infected pigs have been found yet anywhere in Mexico. But Ochoa, the farm manager, said no one from the government has inspected his farm for swine flu.

Juan Lubroth, an animal health expert at the U.N. Food and Agriculture Organization in Rome, supported officials' assessment of the pig situation and said there is no evidence of sick or dying swine in Mexico.

Lubroth noted that Mexico has a surveillance system that previously eliminated an unrelated disease from the country's commercial pig population, which he said is a good indication that they also are conducting adequate reviews of pigs for swine flu.

Dr. Alejandro Escobar Mesa, deputy director for the control and prevention of disease for the state of Veracruz, said the epidemic in La Gloria was a combination of viral and bacterial illnesses, caused by an unusually dry climate.

"The dust dries up the mucous membranes and facilitates environmental conditions for the transmission of illnesses," Escobar said.

But residents here say they are certain that Edgar Hernandez was not the only swine flu victim in their town. Concepcion Llorente, a first-grade teacher in La Gloria, says authorities still owe the town some answers.

"They said that what we had here was an atypical flu, but if the boy tested positive for swine flu, where did he get it from?" she said.

___



AP Medical Writer

Margie Mason and


AP writers

Mark Stevenson and
Lisa J. Adams
in Mexico City

contributed to this report.

[Bianca]

                                         Swine Flu Virus Infects World Stock Markets




       

AP
Adam Smith
/ London
– Mon Apr 27, 2009

As authorities around the world rush to work out where swine flu will turn up next, the movement of markets Monday was far more predictable. With cases of the new H1N1 virus confirmed from Mexico to Spain - and tests on possible cases underway from New Zealand to Britain - investors battled their own nerves. Recovering slightly from earlier losses, Britain's FTSE 100 index of leading shares was down just under 1% in early afternoon trading. Indices in France and Germany, likewise up on their earlier lows Monday, were nonetheless subdued amid the global jitters triggered by the spread of the flu virus. Earlier, shares in Hong Kong closed down 2.74%.


For investors already wounded by the global economic crash, news of a potential pandemic came as a further blow. "As if we didn't have enough to contend with," strategists at the Royal Bank of Scotland wrote in a note to clients Monday, "it's just what we need now, a flu pandemic in the midst of the biggest financial crisis since the Great Depression." Amid the sell-off, travel industry stocks fell sharpest. Shares in Lufthansa, Europe's second-largest airline, tumbled by more than 12% before recovering slightly. Those of rival British Airways pulled back from similar lows, trading 8% down by mid-afternoon in London. Tour operators and hotel groups took similar hits. (See pictures of the swine flu outbreak in Mexico.)


From the volatility of global travel, investors sought the calm of safe havens. Both the dollar and the Japanese yen rose against major currencies. Defensive stocks, such as pharmaceuticals, registered healthy gains. Shares in Roche, the Swiss maker of Tamiflu, an antiviral drug effective against swine flu, had climbed almost 6% by Monday afternoon. Rival GlaxoSmithKline, which makes the influenza treatment Relenza, saw its shares rise even higher. (Read: "Swine Flu: 5 Things You Need to Know About the Outbreak.")


How long stocks hold those positions in the face of the threat from H1N1 remains to be seen. The fact that shares hit hard early had regained lost ground Monday suggests markets had earlier "responded in the time honored fashion," says Howard Wheeldon, senior strategist at BGC Partners in London, namely with "a degree of overreaction."


Given the lack of clarity over the threat posed by the virus, that's perhaps understandable. But gauging the impact of the outbreak - for markets and economies just as for health officials - takes time. Should the virus's potential for a pandemic be realized, though, its financial impact would be severe. As with the outbreak of severe acute respiratory syndrome (SARS), which devastated the Asian economy in 2003, economic consequences would be measured "not so much in the number of people that go down with it, or unfortunately are killed by it," says Justin Urquhart Stewart, investment director at Seven Investment Management in London, but by "the impact of the potential [population] that could be effected. Once it starts to gather momentum, it takes very little to start knocking serious percentage points off global trade and GDP." Right now, that's a momentum we could all do without.

[Bianca]

                               Outbreak Like Mexican Swine Flu Predicted 14 Months Ago
           





Robin Lloyd
LiveScience Senior Editor
– Mon Apr 27, 2009


A team of scientists predicted more than a year ago that Mexico and other tropical locales were emerging "hotspots" for so-called zoonotic diseases that jump from animals to humans, getting it right on the newly reported swine flu.

This week, the scientists are analyzing the patterns of the new swine flu virus's spread and trying to predict its next moves. The researchers "should have preliminary findings by the weekend," team leader Peter Daszak of the Wildlife Trust told LiveScience.

Daszak and his colleagues cautioned in February 2008 that infectious disease-fighting resources are not effectively deployed around the globe and that the U.S. government has not always accurately investigated how flu strains will arrive here.